Animal Sedative Mixed With Fentanyl Brings Fresh Horror to US Drug Zones | Canada News Media
Connect with us

Health

Animal Sedative Mixed With Fentanyl Brings Fresh Horror to US Drug Zones

Published

 on

PHILADELPHIA — Over a matter of weeks, Tracey McCann watched in horror as the bruises she was accustomed to getting from injecting fentanyl began hardening into an armor of crusty, blackened tissue. Something must have gotten into the supply.

Switching corner dealers didn’t help. People were saying that everyone’s dope was being cut with something that was causing gruesome, painful wounds.

“I’d wake up in the morning crying because my arms were dying,” Ms. McCann, 39, said.

In her shattered Philadelphia neighborhood, and increasingly in drug hot zones around the country, an animal tranquilizer called xylazine — known by street names like “tranq,” “tranq dope” and “zombie drug” — is being used to bulk up illicit fentanyl, making its impact even more devastating.

Xylazine causes wounds that erupt with a scaly dead tissue called eschar; untreated, they can lead to amputation. It induces a blackout stupor for hours, rendering users vulnerable to rape and robbery. When people come to, the high from the fentanyl has long since faded and they immediately crave more. Because xylazine is a sedative and not an opioid, it resists standard opioid overdose reversal treatments.

More than 90 percent of Philadelphia’s lab-tested dope samples were positive for xylazine, according to the most recent data.

“It’s too late for Philly,” said Shawn Westfahl, an outreach worker with Prevention Point Philadelphia, a 30-year-old health services center in Kensington, the neighborhood at the epicenter of the city’s drug trade. “Philly’s supply is saturated. If other places around the country have a choice to avoid it, they need to hear our story.”

A study published in June detected xylazine in the drug supply in 36 states and the District of Columbia. In New York City, xylazine has been found in 25 percent of drug samples, though health officials say the actual saturation is certainly greater. In November, the Food and Drug Administration issued a nationwide four-page xylazine alert to clinicians.

Shawn Westfahl, center left, attended to a man who Mr. Westfahl believed had just injected tranq dope, in the Kensington section of Philadelphia.Hilary Swift for The New York Times
Tracey McCann is in recovery from tranq dope at a treatment center near St. Louis. “I’d wake up in the morning crying because my arms were dying,” she said.Neeta Satam for The New York Times

In December, the Office of National Drug Control Policy said it was tracking the spread closely, and the journal Pediatrics published an analysis of three cases of xylazine ingestion by toddlers.

But xylazine’s true prevalence is unknown. Hospitals don’t test for it. Some state medical examiners don’t routinely do so, either.

The drug exists in a legal gray zone. Approved 50 years ago by the F.D.A. as a veterinarian-prescribed analgesic, it is not listed as a controlled substance for animals or humans and so is not subject to strict monitoring. Thus, it has not been on the radar of federal law enforcement for diversion or abuse.

As with many trapped by tranq, Ms. McCann’s hellish descent began with prescription opioids. In 2009, when she was 27, she developed a dependence on painkillers prescribed after a severe car crash. A boyfriend she met at one of her six stays in rehab introduced her to heroin. Cheaper and more potent fentanyl elbowed heroin off the streets. Then, as the Covid-19 pandemic descended in 2020, tranq stormed Philadelphia.

Last July, she was evicted from her room in Kensington. “I was sleeping on the sidewalks crying every night, knowing that I was better than that,” Ms. McCann said. Someone next to her got shot. A man tried to rape her, but she defended herself with a box cutter. On the hot summer streets, she saw people whose tranq wounds were covered with fleas and maggots.

Even so, she said, “I could not pull myself away from that drug.”

Ms. McCann shows a photo of herself last summer shortly before she fled Kensington, when she weighed only about 90 pounds.Neeta Satam for The New York Times

On a recent chilly afternoon, hundreds of people filled the streets surrounding Prevention Point, carrying used syringes to exchange for sterile ones. Some then made their way to the center’s wound care clinic, which has seen a 313 percent rise in visits over the past three years, largely because of tranq.

Brooke Peder, a 38-year-old tattoo artist nicknamed the Hood Grandma, rolled her wheelchair to the exchange check-in and handed over a gallon container filled with syringes. Her mother, sister and wife died of overdoses. Just over a year ago, her right leg had to be amputated because of an infection from a tranq wound that bore into the bone.

Ms. Peder, who has been using drugs in Kensington for 13 years, said she was eager to warn about tranq, especially to newbies arriving in the neighborhood, lured by its decades-old reputation as a drug marketplace. They come from all over the country. Many arrive with money and pay locals to seek out drugs, until they turn into locals themselves, she said.

She unrolled a bandage from elbow to palm. Beneath patches of blackened tissue, exposed white tendons and pus, the sheared flesh was hot and red. To stave off xylazine’s excruciating withdrawal, she said, she injects tranq dope several times a day. Fearful that injecting in a fresh site could create a new wound, she reluctantly shoots into her festering forearm.

At an office at Prevention Point, Ms. Peder changed the dressing on her arm.Hilary Swift for The New York Times

“The tranq dope literally eats your flesh,” she said. “It’s self-destruction at its finest.”

Tranq dope is an ever-fluctuating blend of xylazine, a sedative, and usually an opioid, with each type of drug binding to different brain receptors. While there is ample research on opioids, there is almost none on xylazine in humans. Though it has been detected in fatal overdoses where opioids were present, its direct correlation with fatality is undetermined.

Xylazine was developed in 1962 as an anesthetic for veterinary procedures. Trials in humans were shut down because the drug led to respiratory depression and low blood pressure. Its use as an addictive substitute for heroin most likely started in the 2000s: In 2011, a study observed that people in farming areas of Puerto Rico were injecting “anestesia de caballo” (horse anesthesia) and developing severe skin ulcers.

In Kensington, which has a substantial Puerto Rican population, the drug was found in 2006. But it wasn’t until about 2018 that tranq use began escalating there and then throughout the Northeast. Some epidemiologists theorize that during the pandemic, bottles of domestic xylazine, purchased online with a veterinary prescription or diverted from veterinary supply chains, became popular as a cheap, easy opioid filler.

Unsuspecting Kensington customers saw an advantage to the new mix: A bag of heroin ran about $10, tranq dope $5.

An encampment in the Kensington neighborhood.Hilary Swift for The New York Times
Used needles, Narcan sprays and abandoned belongings on Kensington Avenue.Hilary Swift for The New York Times

But costs accrued. Kim Barauskas, 53, wondered why, after shooting up, she was falling over, waking up later and then immediately feeling that “we’re all sick again and need to get another shot.”

“Most people tell me, ‘I wish I could find dope that didn’t have xylazine,’” said Dr. Joseph D’Orazio, an expert in toxicology and addiction medicine at Temple University Hospital in Philadelphia, which treats dozens of xylazine users daily. “But what gets put out there on the street is what people have to use.”

Reversing an overdose where xylazine was involved is tricky. A dose of the overdose-halting medicine naloxone, which blocks or reverses opioids’ effect on brain receptors, will address the fentanyl but still won’t rouse a victim sedated with xylazine. Desperate rescuers may try a second or third dose. But too much naloxone can put someone into withdrawal, vomiting and writhing.

Responders are advised to check whether the person is breathing, protect the head and airways, apply one dose of naloxone and call for backup.

Even when opioid withdrawal is contained, the harsh xylazine withdrawal continues. People keep using tranq dope for fear of “getting sick”: migraines, double vision, nausea, numbness in fingers and toes, sweats and body-rattling anxiety. There is no medical protocol yet for managing it; Dr. D’Orazio typically uses anti-anxiety drugs to treat the patient’s symptoms.

Kim Barauskas said that right after she accidentally injected tranq into an artery, she felt like her hands had been dipped in acid. Her fingertips may need to be amputated.Hilary Swift for The New York Times

Doctors are perplexed by how xylazine causes wounds so extreme that they initially resemble chemical burns. They may not even appear at injection sites, but often on shins and forearms.

Ms. McCann’s tranq-scorched forearms reeked, oozed, itched and seared. Washing them regularly was nearly impossible, with public restrooms her only source of clean water.

She finally made her way to Prevention Point’s wound care clinic, where nurses debrided sores, dispensed antibiotic ointment and supplies and taught her how to change bandages. Using toenail clippers and alcohol wipes, she meticulously trimmed the eschar.

One day in August, she caught a glimpse of herself: Normally weighing 150 pounds, she was down to 90. “I thought, I either need to do a lethal shot of xylazine or get the hell out of Kensington,” she said.

The only person who would let her use a cellphone was a guy whose arm and leg had been amputated because of his tranq wounds. He was still injecting into his leg stump.

She made her decision.

Now in her fifth month of sobriety at an intensive outpatient program near St. Louis and at a healthy weight, Ms. McCann is both stunned by and proud of her progress. From wrist to elbow, her meandering pink and purple scars are a road map of being lost and found. “People out here might think my arms look really ugly, but they aren’t familiar with tranq wounds yet,” she said. “To me, my arms look really beautiful now.”

Ms. McCann is now in her fifth month of sobriety and back to a healthy weight.Neeta Satam for The New York Times

One afternoon, Mr. Westfahl, who coordinates Prevention Point’s overdose prevention team, walked along Kensington Avenue, handing out free nasal spray doses of Narcan, the opioid overdose reversal medication. He and another outreach worker visited encampments of people on the street, some shooting up tranq dope openly, as local residents and shop workers scurried by in the accumulating darkness. People slumped against parking meters and in doorways, heads lolling, necks twisting. Three huddled around a small bonfire, burning a blanket for fuel.

Within 45 minutes, the two men had given away more than 100 doses of Narcan. They hung blue opioid reversal kits on street poles for anyone to grab, filled with disposable gloves, Narcan and plastic mouth guards for mouth-to-mouth resuscitation.

Already overwhelmed by fentanyl, social welfare organizations, public health officials and clinics are in the early throes of figuring out how to withstand tranq. At least one state, Florida, has listed xylazine as a controlled substance. A comparable federal scheduling would prompt much stricter monitoring of prescriptions and suppliers of the drug, including in online transactions.

An official with the Drug Enforcement Administration who declined to be named said that the agency had been in contact with the F.D.A. and looks forward “to the completion of its scientific and medical evaluation and scheduling recommendation.”

Mr. Westfahl, right, and Carlos Del Valle walked around the Kensington neighborhood handing out Narcan and directing people to wound care and needle exchange clinics.Hilary Swift for The New York Times
Sara Wallace-Keeshen, right, and Kristi Petrillo-Straub, Prevention Point nurses, put together wound care kits for patients. They dress casually rather than in hospital scrubs, hoping to appear nonjudgmental and approachable.Hilary Swift for The New York Times

Some public health experts, noting that tighter controls on diverted prescription painkillers contributed to the rise of illicit fentanyl, questioned whether scheduling xylazine would alleviate its attendant problems, especially if more support programs are not forthcoming.

For now, the practical goal is to minimize xylazine’s damage by educating those who could be exposed, urging them not to use alone. Many leaders in the so-called harm reduction movement are pressing for supervised injection sites, where people can use in safer conditions and even have their drugs tested. Only two exist in the United States, both in New York City, where in 10 minutes people can learn whether their drugs include xylazine.

The Philadelphia health department has also been reaching out to clinicians who work with tranq patients, and Dr. D’Orazio has been lecturing widely about how to manage cases.

But a longstanding obstacle to progress is shame. People who use drugs often feel too mortified by their wounds to come in from the shadows to get help at emergency rooms.

That shame can be perpetuated by health care workers, who may dismiss these patients’ agonizing withdrawal as mere drug-seeking behavior. “Stigma is so deeply entrenched within hospital culture,” said Sara Wallace-Keeshen, a Prevention Point nurse who wears casual clothes rather than medical scrubs, hoping to appear nonjudgmental and welcoming.

Narcan kits and missing person signs are common sights in Kensington.Hilary Swift for The New York Times

Mr. Westfahl continued his journey down Kensington Avenue. Suddenly, at the intersection of Kensington and Allegheny, shouts went up from a gathering crowd: “Get the Narcan!”

A man was splayed out on the sidewalk, unconscious.

Announcing that he had first-aid training, Mr. Westfahl asked people to hold off on Narcan. He pulled on disposable gloves, checked the man’s pulse and opened his mouth to make sure it was free of food, syringe caps — anything he could choke on. Mr. Westfahl tilted the head back to check breathing and keep the airway open. Then, making a fist, he rolled his knuckles briskly up and down the man’s chest in a sternum rub; the surprising pain can jolt someone awake. The man began to come to, stupefied.

Mr. Westfahl and some onlookers hoisted him gently. Still heavily sedated, he lurched in the freezing wind, pants drooping. On either side, two women slipped their hands inside his open, flapping jacket.

They were fumbling for his zipper, which they secured to keep him warm. Then, arms around him, holding him up, the three headed back down Kensington Avenue.

Hilary Swift contributed reporting.

Adblock test (Why?)

Source link

Continue Reading

Health

Health Canada approves updated Moderna COVID-19 vaccine

Published

 on

 

TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

Source link

Continue Reading

Health

These people say they got listeria after drinking recalled plant-based milks

Published

 on

 

TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Source link

Continue Reading

Health

B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

Published

 on

 

VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

Source link

Continue Reading

Trending

Exit mobile version